Dietary and nutritional therapy — People with active RA may lose appetite or be unable to eat enough meals. If you have this condition, nutritional therapy can help you acquire adequate calories and nutrients. If you are overweight or obese, your doctor may advise you to lose weight to relieve stress on your joints. People with RA are more likely to develop coronary artery disease, which raises the risk of a heart attack or stroke. High cholesterol is one risk factor for cardiovascular disease than dietary adjustments can mitigate. A nutritionist can advise you on which foods to eat and avoid to reach a healthy cholesterol level.
Several studies have demonstrated that smoking is a risk factor for RA and that stopping smoking can improve symptoms. If you smoke, you must strive to quit completely. This can be challenging, but your health care professional can assist you.
Moderate alcohol use is not detrimental to RA patients, although it may raise the risk of liver damage linked with some medications, such as methotrexate. If you drink alcohol, it’s vital to talk to your doctor about it because the dangers will vary depending on what drugs you’re on and whether you have other health issues.
Reduced bone loss measures – RA causes a decrease in bone density, leading to osteoporosis. Inactive people are more likely to experience bone loss. In addition, the use of steroid drugs, such as prednisone, increases the risk of bone loss, particularly in menopausal women.
Several interventions can be taken to reduce the bone loss caused by steroid therapy:
- Your provider will prescribe the lowest feasible dose of steroids for the shortest amount of time necessary to manage your condition.
- You can ensure that you get enough calcium and vitamin D through your diet or supplements.
- Your doctor may prescribe drugs to treat bone loss, including those caused by steroids.
MEDICATIONS FOR RHEUMATOID ARTHRITIS
When rheumatoid arthritis (RA) symptoms are active, medications constitute the cornerstone of treatment. The goals of pharmacological treatment are to establish remission of RA symptoms and signs and avoid further joint degeneration and function loss without producing permanent or severe adverse effects.
Individual considerations, as well as potential pharmacological side effects, will determine the optimal medication(s) and dose(s) for you. A medication’s dose is increased until the inflammation is reduced or adverse drug effects become intolerable in most circumstances. However, this balance can be difficult to achieve because the necessity to suppress inflammation must be balanced against the danger of negative effects.
RA is treated with a variety of medications. Disease-modifying antirheumatic medicines (DMARDs), nonsteroidal anti-inflammatory drugs (NSAIDs), steroids, and, if necessary, pain medications are among them.
DMARDs: Disease-modifying antirheumatic medications (DMARDs) can significantly lower RA inflammation, reduce or prevent joint deterioration, preserve joint structure and function, and allow a person to resume normal daily activities. Although some DMARDs take time to work, they may allow you to take fewer steroids to reduce pain and inflammation. DMARDs are classified into numerous types:
- Classic drug-manufacturing procedures generate conventional synthetic DMARDs (also known as traditional DMARDs) such as methotrexate and sulfasalazine.
- Biologic DMARDs, also known as “targeted biologic drugs,” are created by molecular biology (recombinant DNA) procedures. Etanercept, adalimumab, abatacept, and tocilizumab are a few examples.
- Other DMARDs, such as tofacitinib, are manufactured using traditional drug-production procedures; these are similar to biologic DMARDs and are referred to as “targeted synthetic DMARDs.”
Nonsteroidal anti-inflammatory medications (NSAIDs) such as ibuprofen (brand names: Advil, Motrin) and naproxen (brand name: Aleve) may be prescribed to relieve pain and reduce mild inflammation. Your doctor would most likely recommend a greater dose than most people take to alleviate headaches or other minor aches and pains. On the other hand, NSAIDs have little effect on the long-term detrimental consequences of RA on the joints.
NSAIDs must be taken consistently and at a specified dose to maximize their anti-inflammatory action. Even at the recommended doses, NSAIDs typically require several weeks of use before reaching full impact. If the first dose of NSAIDs does not alleviate symptoms, a clinician may advise gradually increasing the dose or switching to another NSAID. It is not advisable to use two different NSAIDs at the same time.
Many NSAIDs cause serious adverse effects, such as gastrointestinal bleeding, fluid retention, and an increased risk of heart disease. Therefore, the risks must be carefully evaluated against the advantages when taking these medications.